Provider Demographics
NPI:1700099199
Name:DOROTHYSTEINOFEASTCHESTER
Entity Type:Organization
Organization Name:DOROTHYSTEINOFEASTCHESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:RUBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-723-6111
Mailing Address - Street 1:707 POST RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-5009
Mailing Address - Country:US
Mailing Address - Phone:914-723-6111
Mailing Address - Fax:914-723-2959
Practice Address - Street 1:707 POST RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5009
Practice Address - Country:US
Practice Address - Phone:914-723-6111
Practice Address - Fax:914-723-2959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0806270001Medicare NSC